Web-Based Video-Coaching to Assist an Automated Computer-Tailored Physical Activity Intervention for Inactive Adults: A Randomized Controlled Trial

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Abstract

Background

Web-based physical activity interventions that apply computer tailoring have shown to improve engagement and behavioral outcomes but provide limited accountability and social support for participants. It is unknown how video calls with a behavioral expert in a Web-based intervention will be received and whether they improve the effectiveness of computer-tailored advice.

Objective

The purpose of this study was to determine the feasibility and effectiveness of brief video-based coaching in addition to fully automated computer-tailored advice in a Web-based physical activity intervention for inactive adults.

Methods

Participants were assigned to one of the three groups: (1) tailoring + video-coaching where participants received an 8-week computer-tailored Web-based physical activity intervention (“My Activity Coach”) including 4 10-minute coaching sessions with a behavioral expert using a Web-based video-calling program (eg, Skype; n=52); (2) tailoring-only where participants received the same intervention without the coaching sessions (n=54); and (3) a waitlist control group (n=45). Demographics were measured at baseline, intervention satisfaction at week 9, and physical activity at baseline, week 9, and 6 months by Web-based self-report surveys. Feasibility was analyzed by comparing intervention groups on retention, adherence, engagement, and satisfaction using t tests and chi-square tests. Effectiveness was assessed using linear mixed models to compare physical activity changes between groups.

Results

A total of 23 tailoring + video-coaching participants, 30 tailoring-only participants, and 30 control participants completed the postintervention survey (83/151, 55.0% retention). A low percentage of tailoring + video-coaching completers participated in the coaching calls (11/23, 48%). However, the majority of those who participated in the video calls were satisfied with them (5/8, 71%) and had improved intervention adherence (9/11, 82% completed 3 or 4 modules vs 18/42, 43%, P=.01) and engagement (110 minutes spent on the website vs 78 minutes, P=.02) compared with other participants. There were no overall retention, adherence, engagement, and satisfaction differences between tailoring + video-coaching and tailoring-only participants. At 9 weeks, physical activity increased from baseline to postintervention in all groups (tailoring + video-coaching: +150 minutes/week; tailoring only: +123 minutes/week; waitlist control: +34 minutes/week). The increase was significantly higher in the tailoring + video-coaching group compared with the control group ( P=.01). No significant difference was found between intervention groups and no significant between-group differences were found for physical activity change at 6 months.

Conclusions

Only small improvements were observed when video-coaching was added to computer-tailored advice in a Web-based physical activity intervention. However, combined Web-based video-coaching and computer-tailored advice was effective in comparison with a control group. More research is needed to determine whether Web-based coaching is more effective than stand-alone computer-tailored advice.

Trial Registration

Australian New Zealand Clinical Trials Registry (ACTRN): 12614000339651; http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12614000339651+&isBasic=True (Archived by WebCite at http://www.webcitation.org/6jTnOv0Ld)

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Most cited references 42

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Meta-analysis of internet-delivered interventions to increase physical activity levels

Cally Davies, John Spence, Corneel Vandelanotte … (2012)

Many internet-delivered physical activity behaviour change programs have been developed and evaluated. However, further evidence is required to ascertain the overall effectiveness of such interventions. The objective of the present review was to evaluate the effectiveness of internet-delivered interventions to increase physical activity, whilst also examining the effect of intervention moderators. A systematic search strategy identified relevant studies published in the English-language from Pubmed, Proquest, Scopus, PsychINFO, CINHAL, and Sport Discuss (January 1990 – June 2011). Eligible studies were required to include an internet-delivered intervention, target an adult population, measure and target physical activity as an outcome variable, and include a comparison group that did not receive internet-delivered materials. Studies were coded independently by two investigators. Overall effect sizes were combined based on the fixed effect model. Homogeneity and subsequent exploratory moderator analysis was undertaken. A total of 34 articles were identified for inclusion. The overall mean effect of internet-delivered interventions on physical activity was d = 0.14 (p = 0.00). Fixed-effect analysis revealed significant heterogeneity across studies (Q = 73.75; p = 0.00). Moderating variables such as larger sample size, screening for baseline physical activity levels and the inclusion of educational components significantly increased intervention effectiveness. Results of the meta-analysis support the delivery of internet-delivered interventions in producing positive changes in physical activity, however effect sizes were small. The ability of internet-delivered interventions to produce meaningful change in long-term physical activity remains unclear.

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Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial.

Deborah Tate, Elizabeth H Jackvony, Rena R Wing (2003)

Weight loss programs on the Internet appear promising for short-term weight loss but have not been studied for weight loss in individuals at risk of type 2 diabetes; thus, the longer-term efficacy is unknown. To compare the effects of an Internet weight loss program alone vs with the addition of behavioral counseling via e-mail provided for 1 year to individuals at risk of type 2 diabetes. A single-center randomized controlled trial conducted from September 2001 to September 2002 in Providence, RI, of 92 overweight adults whose mean (SD) age was 48.5 (9.4) years and body mass index, 33.1 (3.8). Participants were randomized to a basic Internet (n = 46) or to an Internet plus behavioral e-counseling program (n = 46). Both groups received 1 face-to-face counseling session and the same core Internet programs and were instructed to submit weekly weights. Participants in e-counseling submitted calorie and exercise information and received weekly e-mail behavioral counseling and feedback from a counselor. Measured weight and waist circumference at 0 and 12 months. Intent-to-treat analyses showed the behavioral e-counseling group lost more mean (SD) weight at 12 months than the basic Internet group (-4.4 [6.2] vs -2.0 [5.7] kg; P =.04), and had greater decreases in percentage of initial body weight (4.8% vs 2.2%; P =.03), body mass index (-1.6 [2.2] vs -0.8 [2.1]; P =.03), and waist circumference (-7.2 [7.5] vs -4.4 [5.7] cm; P =.05). Adding e-mail counseling to a basic Internet weight loss intervention program significantly improved weight loss in adults at risk of diabetes.

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Test-retest reliability of four physical activity measures used in population surveys.

S. Trost, Neville Owen, K Mummery … (2004)

Accurate monitoring of prevalence and trends in population levels of physical activity (PA) is a fundamental public health need. Test-retest reliability (repeatability) was assessed in population samples for four self-report PA measures: the Active Australia survey (AA, N=356), the short International Physical Activity Questionnaire (IPAQ, N=104), the physical activity items in the Behavioral Risk Factor Surveillance System (BRFSS, N=127) and in the Australian National Health Survey (NHS, N=122). Percent agreement and Kappa statistics were used to assess reliability of classification of activity status as 'active', 'insufficiently active' or 'sedentary'. Intraclass correlations (ICCs) were used to assess agreement on minutes of activity reported for each item of each survey and for total minutes. Percent agreement scores for activity status were very good on all four instruments, ranging from 60% for the NHS to 79% for the IPAQ. Corresponding Kappa statistics ranged from 0.40 (NHS) to 0.52 (AA). For individual items, ICCs were highest for walking (0.45 to 0.78) and vigorous activity (0.22 to 0.64) and lowest for the moderate questions (0.16 to 0.44). All four measures provide acceptable levels of test-retest reliability for assessing both activity status and sedentariness, and moderate reliability for assessing total minutes of activity.

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Author and article information

Contributors

Stephanie Alley:

Physical Activity Research GroupSchool of Human, Health and Social SciencesCentral Queensland UniversityBuilding 77Bruce HighwayRockhampton, 4701Australia61 74923226361 749232265s.alley@cqu.edu.au

ORCID: http://orcid.org/0000-0001-9666-5071

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J. Med. Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: August 2016

Publication date (Electronic): 12 August 2016

Volume: 18

Issue: 8

Electronic Location Identifier: e223

Affiliations

[1] ¹Physical Activity Research Group School of Human, Health and Social Sciences Central Queensland University RockhamptonAustralia

[2] ²Alberta Center for Active Living Faculty of Physical Education and Recreation University of Alberta Edmonton, ABCanada

[3] ³Priority Research Centre for Physical Activity and Nutrition Faculty of Health and Medicine University of Newcastle CallaghanAustralia

Author notes

Corresponding Author: Stephanie Alley s.alley@ 123456cqu.edu.au

Author information

Stephanie Alley http://orcid.org/0000-0001-9666-5071

Cally Jennings http://orcid.org/0000-0001-9017-7077

Ronald C Plotnikoff http://orcid.org/0000-0002-3763-8273

Corneel Vandelanotte http://orcid.org/0000-0002-4445-8094

Article

Publisher ID: v18i8e223

DOI: 10.2196/jmir.5664

PMC ID: 5002066

PubMed ID: 27520283

SO-VID: 927122fd-5c16-4e50-a69b-985e9e7abe3a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 29 February 2016

Date revision requested : 19 April 2016

Date revision received : 1 June 2016

Date accepted : 13 June 2016

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